Interaction with other drugs | Xarelto®

Interaction with other drugs

Some medications for fungal infections or HIV can inhibit the breakdown mechanisms of Xarelto® , so that higher doses of Xarelto® are present in the body. This increases the risk of bleeding. Some antibiotics have a similar, but somewhat weaker effect on Xarelto®.

Other anticoagulants also increase the risk of bleeding. Drugs that increase the breakdown process of Xarelto® can weaken its effect and thus lead to thrombi and strokes. The contraceptive pill is a widely used contraceptive measure and, since women taking Xarelto® should be careful about contraception, a possible safeguard.

However, since Xarelto® is partially converted and broken down by a mechanism that is also responsible for the pill, the effect of both substances can be altered. Contraception is therefore not as safe as it is in people who do not take Xarelto. Additional contraception, for example with condoms, is advisable.

Contraindications for Xarelto

Young women should make sure they use good contraception, as pregnancy and breastfeeding are contraindications for taking Xarelto®. Certain liver diseases with an influence on blood clotting can also rule out the use of Xarelto®. If kidney function is significantly impaired, Xarelto® may also not be used or the dose may be reduced because part of the drug is excreted via the kidneys.

Xarelto® should not be taken prior to spinal cord anesthesia or surgery with significant blood loss. Studies have shown that the active ingredient rivaroxaban contained in Xarelto® can pass through both the placental barrier and breast milk. If it passes through the placenta, the unborn child may be poisoned and the risk of bleeding for mother and child is too high.

Xarelto® should therefore not be taken during pregnancy or while breast-feeding. If the indication for anticoagulation is still present, alternative medication should be considered and the mother’s blood clotting should be closely monitored. Xarelto® is partially metabolized and excreted via the kidneys.

In the case of severe limitations in kidney function, this breakdown may be inhibited. This means that the active ingredient remains in the blood for longer and also acts for longer. Depending on the severity of the impairment, the dosage of Xarelto® must therefore be adjusted.

Alternative substances should be used for patients requiring dialysis, as Xarelto® cannot be completely filtered out during dialysis. Dosing is therefore difficult or even impossible. Colloquially, alcohol has a blood-thinning effect, i.e. it has an effect on blood clotting.

This is precisely where Xarelto® also has an effect, which is intended to specifically reduce blood clotting.Combined use of Xarelto® and alcohol can increase the risk of bleeding and lead to life-threatening internal bleeding or nosebleeds. Alcohol should therefore be avoided if possible while taking Xarelto®. Especially large amounts of alcohol should be strictly avoided.